Healthcare Provider Details

I. General information

NPI: 1831920164
Provider Name (Legal Business Name): KYLA CHENEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2024
Last Update Date: 08/08/2024
Certification Date: 08/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4516 S 700 E STE 260
MURRAY UT
84107-8317
US

IV. Provider business mailing address

5169 W SOUTH JORDAN PARKWAY
SOUTH JORDAN UT
84009
US

V. Phone/Fax

Practice location:
  • Phone: 385-293-1902
  • Fax:
Mailing address:
  • Phone: 435-890-7220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: